A Study on Translating Therapist Skills into Client Improvement in the Real World
And the challenges of automated feedback systems. Frontiers Friday #235 ⭕️
How does deliberate practice (DP) translate in the real-world?
Is it possible to work on skills deficits at the therapist level, leading to overall improvement at the client level?
That’s exactly what Sam Malins, our co-author of The Field Guide to Better Results, did. Sam and his colleagues sampled therapists and their clients from the National Health Service (NHS) in England, and conducted a feasibility study to examine the utility of a 10-week program using principles of DP alongside with an automated feedback system, targeting therapists’ individualised skill deficits.
Spanning across three different time zones in US, UK and Australia, Scott Miller and I interviewed Sam about his intriguing real-world study. You can find the interview on the ICCE youtube channel:
Feel free to go to different parts of the interview using the timestamps below.
Timestamps:
0:00 – Intro
1:20 – History with deliberate practice research
3:21 – How Sam's study differs from prior deliberate practice books/research
6:19 – Key difference between this naturalistic study design and a traditional RCT
11:37 – How therapist skill deficits were actually identified (TDPA + feedback)
13:45 – Challenges of running the study inside the NHS (recruitment, protecting time)
16:19 – Findings: Large effects on therapist skill (FIS), high feasibility/acceptability
21:12 - Unique features of this DP study
27:45 – Challenges with machine learning automated feedback
31:46 – What's next: Sam's plans for future research (larger RCT, therapist-level comparison)
36:36 – Biggest threats/barriers to adopting this approach in routine clinical practice
You can find the full study here (open access).
I know how hard it is to conduct such a naturalistic study, which is why I am deeply appreciative of Sam Malin and his colleagues efforts, along with the participation of an already overworked therapist group who were part of the investigation.
There is a growing body of studies in DP. And there are also other researchers around the world who are empirically testing out these ideas. More to come.
If you are interested in identifying your own growth edge, check out our previous posts on the Taxonomy of Deliberate Practice Activities (TDPA) worksheet. You can download the worksheet in Part I.
I also recommend checking out Part IV. Taken from Chapter 2 of The Field Guide, I provide a clinical example of a therapist using the TDPA to improve her work over time.
Notice Board
2-DAY WORKSHOP IN PERTH:
For the first time in Perth, I am conducting a Special In-Person 2-DAY Workshop on 26-27 Nov 2026.
Day I is for clinical supervisors and those aspiring to be;
Day II is for all therapists, which is a day of deep reflection and renewal.
Early Bird is available til the end of July 2026, along with a bonus discount for attending both days.
Certs will be provided for CPD hours where eligible.
I hope you will join us.
Because this is independently run, may I seek your help to share this with your colleagues who might be interested too.
More details and to register, click this button.
BETTER RESULTS CAFE:
The online Better Results Cafe (formerly called DP Cafe) Cohort #5 is now open for registration!
Along with an intimate group of practitioners from all over world, join Scott Miller and I in these four online meetings. This is for those interested in using feedback and deliberate practice to improve their clinical effectiveness.
Dates: November 10, 17, 24, and December 1, 2026 (1.5 hrs/session; timings are shown in the registration according to your time zone).
Daryl Chow Ph.D. is the author of The First Kiss, co-author of Better Results, The Write to Recovery, Creating Impact, and The Field Guide to Better Results. Plus, the latest book on helping people make life transitions, Crossing Between Worlds.
You might be interested in my other Substack, Full Circles: Field Notes on the Inner and Outer Life. FC is a return to soul and sanity, beyond the hollow promises of self-help tips and tricks.
